Provider Demographics
NPI:1629119870
Name:PHILLIPS, JULIA MAY (APRN)
Entity Type:Individual
Prefix:MS
First Name:JULIA
Middle Name:MAY
Last Name:PHILLIPS
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3254 PATY DR.HONOLULU,HI
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96822
Mailing Address - Country:US
Mailing Address - Phone:808-988-1219
Mailing Address - Fax:808-947-5978
Practice Address - Street 1:1500 S BERETANIA ST
Practice Address - Street 2:SUITE 105
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1932
Practice Address - Country:US
Practice Address - Phone:808-946-4814
Practice Address - Fax:808-947-5978
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAPRN-819101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI25221OtherHMSA PROVIDER #